A Delphi study to determine baseline informatics competencies for nurse managers

The objective of this research study was to produce a job-specific list of informatics competencies for generic nurse manager positions. In 2002, Staggers et al (Nurs Res. 2002;51(6):383-390) identified a list of core nursing informatics competencies at four levels of nursing practice but concluded that job-specific competencies still needed to be developed. An expert panel utilized the Master List of Nursing Informatics Competencies produced in the 2002 study by Staggers et al to define the job-specific informatics competencies appropriate for generic nurse manager positions. A three-round Delphi study was utilized to establish the core competencies appropriate for this job-specific position. Participants were expert informatics nurses in the US Veterans' Healthcare System. Based on the Four Levels of Practice defined in the 2002 study by Staggers et al, the panel identified the level 2 experienced nurse as most appropriate for generic nurse manager positions. For the purposes of review, each practice level was considered to include the competencies of the levels below it. Therefore, having selected level 2 experienced nurse, this necessitated the review of levels 1 and 2, which totaled 69 competencies. From the available 69 competencies, the panel selected a total of 49 core competencies appropriate for generic nurse manager positions. This Delphi research study chose to focus on a single job-specific position to take one small step toward the recommendation of Staggers et al to identify job-specific competencies. The generic nurse manager position was selected as it is a vital position in providing leadership and support within all institutions. While the study raises several questions about how the panel elected some competencies over others, it also begins to define which levels of competencies and categories are most appropriate. With this information at hand, the next logical step would be to establish associated tools for competency development and evaluation, which could then be used to properly prepare and review individuals for the associated nurse manager responsibilities.     

A Delphi study to determine informatics competencies for nurses at four levels of practice

BACKGROUND: Despite its obvious need, a current, research-based list of informatics competencies for nurses is not available. OBJECTIVE: To produce a research-based master list of informatics competencies for nurses and differentiate these competencies by level of nursing practice. METHODS: After a comprehensive literature review and item consolidation, an expert panel defined initial competencies. Subsequently, a three round Delphi study was conducted to validate the items. Participants were expert informatics nurse specialists in the United States of America. RESULTS: Of the initial 305 competencies proposed, 281 competencies achieved an 80% or greater agreement for both importance as a competency and appropriateness for the correct practice level. Five competencies were rejected. Six competencies were considered valid competencies but the appropriate level of practice could not be agreed upon. Thirteen competencies did not reach any consensus after the three Delphi rounds. DISCUSSION: The Delphi study had a high rate of participation, demonstrating the great level of interest and need for a list of informatics competencies for nurses. Out of the initial 305 competencies, only 24 items were not validated. Respondents commented during each round about whether computer skills should be considered informatics competencies. The authors propose that computer skills, while not high level, are one set of tools within the larger category of informatics competencies. This sample of experts did not deem programming skills as necessary for informatics nurses. This research study is an initial effort to fill the void of valid and reliable informatics competencies. It is the first study to span four levels of nurses, create competencies for both entry-level and experienced informatics nurse specialists, and examine the categories of computer skills, informatics knowledge and informatics skills.     

Defining and integrating informatics competencies into a hospital nursing department

Expanding use of complex patient information management systems and communication technology in healthcare organizations requires nurses to possess core competencies that until recently were not considered as integral to practice as those of a strictly clinical nature. Organizational changes necessary to formally integrate informatics competencies into nursing practice require strong partnerships among facility nursing leaders, educators, and informaticists. The authors describe a strategic initiative one acute care organization used to develop nursing practice that ensures use of system tools to manage patient information, support clinical decision making, optimize workflow, and communicate with members of the care team. The initiative involved defining nursing computer and informatics management skills for the clinical system applications and technologies utilized in the organization and integrating the introduction, evaluation, and on going professional development of the defined informatics competencies into organizational processes and tools to support the bedside nurse.     

Computer competencies in a BSN program

Beginning nurses need informatics skills to work efficiently in an environment that increasingly relies on information technology to promote patient safety. In addition, a federal order mandates that all Americans have an electronic medical record by 2014. Nursing programs must integrate informatics content into their curricula to prepare nurses to use information technology. This article describes a baccalaureate (BSN) curriculum evaluation of nursing informatics content. Results can inform faculty about strategies that can strengthen informatics competencies. A research-based tool, based on the informatics competence work of Staggers, Gassert, and Curran, was developed to evaluate course syllabi. Although evidence of learning experiences related to computer skills was present, students were not routinely exposed to computerized systems. No syllabi included evidence that addressed informatics knowledge competencies. We conclude that students received limited informatics exposure and may not be adequately prepared to use information technology. Recommendations for increasing nursing informatics experiences within a BSN curriculum are offered.     

Technology and informatics competencies

Health care information technology has the potential to achieve clinical transformation. Nursing students and faculty must be able to use these tools effectively to use data and knowledge in their practice. This article describes informatics competencies for four levels of nurses (beginning nurses, experienced nurses, informatics specialists, and informatics innovators). Recent activities to include informatics competencies in program outcomes are also described in relation to the clinical nurse leader, doctorate of nursing practice, and baccalaureate essentials documents.     

Quality and Safety Education for Nurses

Quality and Safety Education for Nurses (QSEN) addresses the challenge of preparing nurses with the competencies necessary to continuously improve the quality and safety of the health care systems in which they work. The QSEN faculty members adapted the Institute of Medicine(1) competencies for nursing (patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics), proposing definitions that could describe essential features of what it means to be a competent and respected nurse. Using the competency definitions, the authors propose statements of the knowledge, skills, and attitudes (KSAs) for each competency that should be developed during pre-licensure nursing education. Quality and Safety Education for Nurses (QSEN) faculty and advisory board members invite the profession to comment on the competencies and their definitions and on whether the KSAs for pre-licensure education are appropriate goals for students preparing for basic practice as a registered nurse.     

Informatics competencies for nurse managers and their staffs

Nurses have always dealt with data, information, and knowledge. Therefore, as automated information systems become increasingly important in health care, all nurses should have core competencies in computer skills and data and information management. These competencies differ according to the skill level of the nurse, from a beginning nurse to nursing manager, and on to those who specialize in nursing informatics.     

An evidence based approach to undergraduate physical assessment practicum course development

Physical assessment is an important component of professional nursing practice. New nurse graduates experience difficulty transitioning the traditional head to toe physical assessment into real world nursing practice. This study was conducted to provide current data concerning physical assessment competencies utilized consistently by registered nurses. This quantitative study used a 126 item survey mailed to 900 Registered Nurses. Participants used a Likert-type scale to report frequency of use for physical assessment competencies.Thirty seven competencies were determined to be essential components of the physical assessment, 18 were determined supplemental, and 71 were determined to be non-essential. Transition of the new graduate nurse into professional practice can be enhanced by focusing content in physical assessment practicum courses on the essential competencies of physical assessment.Faculty for the university has analyzed data from this study to support evidence based changes to the undergraduate nursing program physical assessment practicum course.     

Nursing informatics: the key to unlocking contemporary nursing practice

Nursing informatics is a relatively new nursing specialty. Recognized by the American Nurses' Association in 1992, this field within nursing has grown exponentially. Once the purview of highly specialized individuals, nursing informatics has now crept into all dimensions of nursing, from domain of advanced nurse practitioners to prominence in critical care nursing. Nowhere is the management and processing of health-related information more important than in the care of the critically ill patient. Fast-paced environments, split-second decision making, wireless communications, monitoring systems run with computerized backbones, and computerized ordering and documentation, all things unimaginable just a decade ago, are now fundamental to nursing practice. Each requires a baseline understanding of informatics for true mastery. The domain of nursing informatics continues to grow as nursing incorporates expanded roles and new technology into practice. Education for nurse informaticians includes preparation from the baccalaureate level through the doctorate level and national board certification. Areas of practice are expansive, including hospitals, industry, education, policy-making, research, administration, and international settings. Although informaticians work with computers, computing technology is not the heart of the domain. Computers are simply tools that are used. Examples of informatics tools include handheld devices, point-of-care documentation, computerized provider order entry, and bar code medication administration. Nursing informatics plays an essential role in the future directions of healthcare by defining the relationship between nurses and information technology as well as the knowledge that can be gained when these domains work together.     

Cultivating informatics competencies in a community of practice

To move the healthcare industry into the 21st century, nurses must become savvy in the use of informatics to provide optimal care to their patients. However, the relatively few formal nursing informatics programs that exist across the country are simply not adequate to meet the demands of both new and existing nurses. Informatics competencies must be incorporated into nursing curricula at entry-level and via staff development to provide a ready workforce. Creative faculty development strategies that capitalize on the concept of faculty as a community of practice are required to incorporate informatics competencies into nursing curricula.     

Informatics competencies for nurses at four levels of practice

Valid and comprehensive nursing informatics (NI) competencies currently are lacking. Meanwhile, nursing leaders are emphasizing the need to include NI in nursing curricula, as well as within the roles of practicing nurses in all settings. This article presents the initial work of a team of NI experts toward development of a valid and reliable set of NI competencies. Previous work primarily has focused on computer-related skills, rather than examining a broad definition of informatics competencies. For this current work, NI competencies encompass all skills, not only computer-related skills, as well as knowledge and attitudes needed by nurses. The first two authors created a database of NI competencies from the existing literature. A larger panel of NI experts then affirmed, modified, added, or deleted competencies from this database. Competencies were placed into four distinct skill levels. Definitions of each skill level and an initial master list of competencies are provided.     

Instrumentos de análisis para el desempeño de la enfermera de práctica avanzada

Advanced Practice Nursing has been a reality in the international context for several decades and recently new nursing profiles have been developed in Spain as well that follow this model. The consolidation of these advanced practice roles has also led to of the creation of tools that attempt to define and evaluate their functions. This study aims to identify and explore the existing instruments that enable the domains of Advanced Practice Nursing to be defined. A review of existing international questionnaires and instruments was undertaken, including an analysis of the design process, the domains/dimensions defined, the main results and an exploration of clinimetric properties. Seven studies were analysed but not all proved to be valid, stable or reliable tools. One included tool was able to differentiate between the functions of the general nurse and the advanced practice nurse by the level of activities undertaken within the five domains described. These tools are necessary to evaluate the scope of advanced practice in new nursing roles that correspond to other international models of competencies and practice domains.     

The internationalization of the nursing profession in Taiwan

Globalization, nursing manpower migration, and the multinational nature of the medical industry have increased the level of internationalization in Taiwan's nursing profession. In nursing practice, competencies for the general nursing list (Taiwan version) and ICNP (International Classification for Nursing Practice) have been clinically tested and revised. In academic nursing, significant effort is invested toward achieving the three general objectives of internationalized teaching, internationalized campuses, and international academic exchanges. We should further test and revise Taiwan's competencies for the general nursing list, and the ICNP should be continually tested and revised. Additionally, nursing personnel should strengthen foreign language competencies, appreciate different nursing practice cultures, participate in international exchange activities, and place increasing emphasis on international cooperation in research and nursing education accreditation. Such should further enhance and strengthen international cooperation, which should further encourage internationalization in the domestic nursing profession.     

Integrating informatics into undergraduate nursing education: A case study using a spiral learning approach

A gap in informatics expertise amongst nursing students, practising staff and faculty has been noted globally, which reduces the potential for nurses to utilise technology to enhance patient care. National nursing education strategies and recommendations from professional associations have identified digital health as an area that needs investment. This case study describes how health informatics is being integrated into a Bachelor of Nursing programme in the United Kingdom. An international collaboration with a US-UK Fulbright Specialist Scholar enabled individual learning units corresponding to key health informatics competencies to be designed and incorporated into a pedagogic framework grounded in the spiral learning approach. This approach is proposed as one way to integrate informatics into nursing education, so students can become competent clinicians that are able to deliver technology enabled care in the health service.     

Nurse endoscopist training: the next step.

Nurses have been successfully performing flexible sigmoidoscopy since the early 1970s. There are numerous studies, in both medical and nursing literature, indicating that nurses can perform this traditional physician role safely and efficiently. Both the American Society of Gastroenterology Endoscopists (ASGE) and Society of Gastroenterology Nurses and Associates (SGNA) have endorsed this practice. Programs appropriate for training the nurse endoscopist, however, have not been defined. Although similarities exist in the literature about how nurses and other nonphysician endoscopists are trained, there are also many discrepancies. If nurses are to take a proactive stance in overseeing nursing practice, objective criteria and clinical competencies need to be established. This is the next step in establishing standard acceptance by the medical community and public.     

The Henry street consortium population-based competencies for educating public health nursing students

The Henry Street Consortium, a collaboration of nurse educators from universities and colleges and public health nurses (PHNs) from government, school, and community agencies, developed 11 population-based competencies for educating nursing students and the novice PHN. Although many organizations have developed competency lists for experts, the Consortium developed a set of competencies that clearly define expectations for the beginning PHN. The competencies are utilized by both education and practice. They guide nurse educators and PHNs in the creation of learning experiences that develop population-based knowledge and skills for baccalaureate nursing students. Public health nursing leaders use the competencies to frame their expectations and orientations for nurses who are new to public health nursing. This paper explains the meaning of each of the 11 population-based competencies and provides examples of student projects that demonstrate competency development. Strategies are suggested for nurse educators and PHNs to promote effective population-based student projects in public health agencies.     

Differentiating nursing leadership and management competencies

As the foundation of evaluating content for nursing leadership and administration courses, leadership and management competencies were identified from a literature review of 140 articles published between 2000-2004. Similarities and differences among the competencies were assessed. A large intersection of common competencies was discovered, indicating a lack of discrimination between leadership and management competencies. Arguably, this fusion ignores the different purposes served by leadership and management. Alternately, the convergence of leadership and management competencies might reflect that traditional distinctions have narrowed. Nevertheless, ambiguity persists regarding essential leadership and management competencies and the way they are reflected in nursing curricula. If concerns about the work environment are to be remedied for patients and staff, nurse educators are urged to act quickly to identify requisite competencies and better align course content with them. This will better prepare nurse administrators to succeed in their arduous work.     

三级甲等医院护士护理信息能力现状的调查

目的调查三级甲等医院护士护理信息能力的现状,探讨护士信息能力培养的重要性。方法采用问卷调查法对6家三级甲等医院300名护士进行护理信息能力现状的调查。结果有63．33％的护士接受过1个月以内的临床护理信息知识的培训;47％的护士并不熟悉PDA和移动查房推车等护理终端设备的使用;53．67％的护士可熟练使用HIS中的NIS子系统;能够通过NIS对护理资料进行收集、整理和分析,最后做出护理决策的护士仅占11．33％。结论基于临床护理信息化的现状,护理教育者和临床护理管理者要增强护士信息能力培养意识,充分重视和开展护士信息化能力的培训,从而促进护理信息事业的进步和发展。     

Preparation of academic nurse educators

Nursing practice is diverse, with nurses serving in both direct and indirect patient care roles. For nurse educators, the realm of nursing practice extends beyond direct patient care to include preparing students for nursing practice. Academic nurse educators must be prepared to serve as educators, researchers, and to have experience in a clinical specialty area. For many nurse educators, advanced academic preparation often relates to a clinical area of practice rather than pedagogical practice. Graduate-level knowledge of evidence-based research and practice, teaching methods, and curriculum design and development form the foundation for academic practice. Because education and nursing are two distinctive disciplines, clinical expertise does not naturally result in teaching expertise. Lack of consensus regarding the educational preparation of nurse educators adds to the complexity of the nursing profession. The purpose of this article is to advocate for pedagogical preparation for academic nurse educators. Additionally, this article contains recommendations for pedagogical competencies indicative of academic nurse educator preparation.